Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | MD064719L | PA |
NPI | 1679545461 |
---|---|
Provider Name | Anita Bhandari |
First Address | Philadelphia, PA 19107 |
Second Address | Philadelphia, PA 19104 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2006 |
Last Update Date | 12/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0017418840002 | (05) | PA |
0017418840008 | (05) | PA |
0017418840009 | (05) | PA |
524394 | MEDICARE (01) | PA |
G99108 | (02) |